RevDive

#47 - Optimizing Revenue Cycle Management in Healthcare: Insights from Paola Turchi

Kem & Taya — Wed, 31 Jan 2024 12:42:17 -0500

Welcome back RevDivers! Tune in to hear Paola Turchi, the RCM Solutions Lead at Notable.

Highlights:

Key challenges in revenue cycle management within the healthcare sector.
In-depth discussion on managing prior authorizations effectively.
Strategies to improve patient collections and satisfaction.
The role of technology in streamlining healthcare RCM processes.
Expert insights and practical tips for healthcare professionals.

Learn more about Notable here: https://www.notablehealth.com/
Guests LinkedIn: https://www.linkedin.com/in/paola-turchi-mshca-fhfma-facmpe-cpc-4836727/
Company LinkedIn: https://www.linkedin.com/company/notablehealth/

Thanks to our sponsor Boston Software Systems, find more about them here for: https://www.bostonsoftwaresystems.com/Home

Subscribe to the Slice of Healthcare Network to be notified for new episodes: https://youtube.com/@sliceofhealthcare?feature=shared

#46 - The Power of Healthcare Payment Data Transparency

Kem & Taya — Wed, 20 Dec 2023 13:44:45 -0500

Welcome back RevDivers! Tune in to hear Anne Saulnier, CEO, and John Hobart, Co-Founder, of HexIQ.

Discussion on healthcare payment data transparency with Anne and John from Hex IQ.
Insights into the Transparency in Coverage Rule and its impact on the healthcare industry.
The role of accessible data in empowering healthcare providers and practices.
The significance of data transparency in creating equitable healthcare systems.
How Hex IQ's Pulse Medical platform is transforming access to healthcare data.

Learn more about HexIQ here: https://hexiq.com/

Thanks to our sponsor Boston Software Systems, find more about them here for: https://www.bostonsoftwaresystems.com/Home

Subscribe to the Slice of Healthcare Network to be notified for new episodes: https://youtube.com/@sliceofhealthcare?feature=shared

#45 - Revolutionizing Healthcare: The Inspiring Journey of Valley Oaks Medical Group

Kem & Taya — Wed, 06 Dec 2023 17:24:18 -0500

Welcome back RevDivers! Tune in to hear Kim Grana, Chief Executive Officer, and Marie Price, Vice President of Operations, at Valley Oaks Medical Group.

Discusses the rapid growth and innovative patient-centered care approach of Valley Oaks.
Insights into their unique strategy in healthcare management and value-based care.
Lessons in leadership and the importance of teamwork in healthcare settings.
Challenges faced during their expansion and how they turned them into opportunities for growth.
Essential listening for anyone interested in healthcare innovation and management.

Learn more about Valley Oaks Medical Group here: https://valleyoaksmed.com/

Thanks to our sponsor Boston Software Systems, find more about them here for: https://www.bostonsoftwaresystems.com/Home

Subscribe to the Slice of Healthcare Network to be notified for new episodes: https://youtube.com/@sliceofhealthcare?feature=shared

#44 - Chock-full of MGMA

Kem & Taya — Wed, 18 Oct 2023 14:59:58 -0400

Welcome back RevDivers! Tune in to hear Craig Wiberg, Senior Manager, Digital Events at MGMA as he gives a sneak peek of the MGMA Leaders Conference 2023.

Elevate Your Leadership Skills
Network with Industry Experts
Access Valuable Resources
Participate in Workshops & Sessions
Book Launch Party: "Advanced Strategies for Financial Management"
How to grow, learn, and connect

Learn more about MGMA here: https://www.mgma.com/conferences/leaders/overview

Thanks to our sponsor Boston Software Systems, find more about them here for: https://www.bostonsoftwaresystems.com/Home

Subscribe to the Slice of Healthcare Network to be notified for new episodes: https://youtube.com/@sliceofhealthcare?feature=shared

#43 - Using A.I. To Change The Future of Medicine In The Home

Kem & Taya — Tue, 12 Sep 2023 07:00:00 -0400

Welcome back to RevDive! Listen to hear Charles Gellman, CEO and Chief Patient Advocate of HIDO Health as they talk about AI-assisted robotics, remote patient montoring, and tech that can reshape the healthcare system.

What you’ll get out of this episode:

Dive deep with Kem Tolliver & Charles Gellman.
Discover the future of healthcare with HIDO's AI-assisted robotics.
Unravel the mysteries of remote patient monitoring (RPM).
Understand the true power of patient satisfaction in healthcare transformation.
Insights into how technology can reshape the healthcare system.

Learn more about HiDO Health here: https://us.hidohealth.com/

Subscribe to the Slice of Healthcare Network to be notified for new episodes: / @sliceofhealthcare

#42 - Reducing Painpoints Between Payers and Providers, ft. Russ Thomas, CEO of Availity

Kem & Taya — Wed, 30 Aug 2023 07:00:00 -0400

Welcome back to RevDive! Listen to hear Russ Thomas, Chief Executive Officer at Availity discuss proactive revenue cycle management, reducing denials and overpayments, and the critical importance of payer-provider collaboration in healthcare

What you’ll get out of this episode:

- Latest episode features Russ Thomas from Availity discussing future of healthcare.
- Critical insights into proactive revenue cycle management and reducing denials and overpayments.
- Deep dive into the complexities and solutions in payer-provider collaboration.
- Russ Thomas introduces AuthAI, technology that reduces denials by 7%.
- Clearinghouses play a pivotal role in efficient revenue cycle management.

Learn more about Availity here: https://www.availity.com/

And make sure to subscribe to the Slice of Healthcare Network:

/ @sliceofhealthcare

#41 – Voices Of Innovation: Fulfilling The Promise Of Information Technology

Kem & Taya — Wed, 02 Aug 2023 08:10:48 -0400

Welcome back to RevDive! Listen to hear Ed Marx, Chief Executive Officer at Marx Advisory discuss healthcare technology advancements and philanthropy.

What you'll get out of this episode:

- "Voices of Innovation" is a book featuring inspiring stories of healthcare technology advancements.
- The book showcases a practical innovation framework with real-life examples from 35 contributors.
- By being part of the book, healthcare practices and hospitals gain recognition and elevate their brand.
- All author proceeds from the book are donated to the Mary Crowley Cancer Research Center.
- To overcome technology aversion, individuals are advised to embrace technology in their personal lives first.
- "Scrappy innovation" highlights the power of simplicity in driving groundbreaking results in healthcare technology.

Learn more about Ed Marx here: https://www.marxadvisory.com/

And make sure to subscribe to the Slice of Healthcare Network:

/ @sliceofhealthcare

#40 - The Implications of A.I. In The Coding World with Andrew Lockhart, CEO and Co-Founder of Fathom Health

Kem & Taya — Wed, 19 Jul 2023 23:30:00 -0400

Welcome back to RevDive! Listen to hear Andrew Lockhart, Co-Founder and CEO at Fathom Health discuss AI and it's implications in the coding world.

What you'll get out of this episode:

AI is enhancing medical coding efficiency and workflows
Tackling coder shortages, allowing staff to focus on challenging tasks
How AI's predictive insights are improving coding audits, chart reviews, and business decisions
AI's future role could include complex decision support and autonomous scribing
AI use can boost job satisfaction, retention, and provide a competitive advantage in healthcare.

To learn more about Andrew Lockhart please use the link below:
- LinkedIn

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Taya https://www.linkedin.com/in/tayagordon/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#39 - How Organizations Can Save Money and Address Overlooked Costs with Matthew McCreith, Strategic Partner at Schooley Mitchell

Kem & Taya — Wed, 07 Jun 2023 07:00:00 -0400

Welcome back to RevDive! Listen to hear Matthew McCreith, Strategic Partner at Schooley Mitchel discusses how organizations can save money and address overlooked costs.

What you'll get out of this episode:

Billing errors and frequency
Client perspective on scrutinizing invoices
Challenges with managing invoices and contracts
Impact of incremental cost increases and right-sizing
Vendor selection and negotiation
Review frequency for invoices and contracts

To learn more about Matthew McCreith please use the link below:
- LinkedIn

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Taya https://www.linkedin.com/in/tayagordon/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#38 - Yielding Success For All Through Education, with Dr. Mary Awuonda, Associate Professor at Howard University College of Pharmacy

Kem & Taya — Wed, 26 Apr 2023 10:13:36 -0400

Welcome back to RevDive! Join as Dr. Mary Awuonda, Associate Professor at Howard University College of Pharmacy discusses how she's pioneering a revenue cycle curriculum to prepare a public informatics workforce.

What you'll get out of this episode:

Dr. Awuonda’s background
Preparing a public informatics workforce at Howard University
The PHIT4DC program
Developing the curriculum with Zane Networks, DC Primary Care Association, Crisp DC & more
How the industry can replicate this effort nationally

To learn more about Dr. Awuonda please use the link below:
- LinkedIn

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Taya https://www.linkedin.com/in/tayagordon/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#37 - Data Security in Healthcare with Jeffrey Miller, JD, Director in Charge at Granite GRC & Vidal Lupian, Director of Information Technology at Granite GRC

Kem & Taya — Wed, 12 Apr 2023 09:00:00 -0400

Welcome back to RevDive! Join as Jeffrey Miller, JD, Director in Charge at Granite GRC & Vidal Lupian, Director of Information Technology at Granite GRC join RevDive to discuss data & data security in healthcare.

What you'll get out of this episode:

Financial data elements in healthcare that matter
How to keep your data protected, and what makes data vulnerable
How to prevent data breaches & identify phishing scams

To learn more about Granite GRC please use the links below:
- Website - LinkedIn

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Taya https://www.linkedin.com/in/tayagordon/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#36 - Supply Chain Challenges & Solutions with Richard Palarea, CEO at Kermit

Kem & Taya — Thu, 23 Mar 2023 11:38:50 -0400

Welcome back to RevDive! Join as Richard Palarea, CEO at Kermit joins RevDive to discuss challenges & solutions in supply chain management.

What you'll get out of this episode:

His background & the background of Kermit
The trending supply chain challenges including high margins, staffing shortages, and more
What work flow optimization is looking like in the supply change industry
What to do to prioritize supply chain management

To learn more about Kermit please use the links below:
- Website - LinkedIn

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Taya https://www.linkedin.com/in/tayagordon/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#35 - Healthcare's Balancing Act with Dr. Jonathan Baktari, MD - Navigating Consolidation, Reimbursements, and Non-Physician Providers

Kem & Taya — Wed, 01 Mar 2023 10:35:57 -0500

Welcome back to RevDive! Join as Dr. Jonathan Baktari, MD - Healthcare CEO, Preventative Medicine Expert, Host of Baktari MD joins RevDive to discuss Healthcare's Balancing Act - Navigating Consolidation, Reimbursements, and Non-Physician Providers.

Episode Summary:

In this episode, we discuss care delivery evolution and the impact of consolidation. As care options impact quality scores, healthcare providers are forced to integrate metrics into care delivery while taking inflation into consideration.

Dr. Baktari discusses healthcare service enhancers, such as ultrasounds, nerve conduction studies, vitamins, and Botox - which are becoming commonplace.

With the need to expand the reach of healthcare providers, there has been a rise in utilization of non-physician clinicians, such as physician assistants and nurse practitioners. Dr. Baktari discusses this rise the need for balance in provider relations. The podcast also delves into the pendulum swing of care delivery modalities, with patients' preference of telehealth even as we exit the COVID-19 Public Health Emergency on May 11, 2023.

What you'll get out of this episode:

The healthcare industry is evolving, and healthcare consolidation is becoming more common.
Reimbursement fluctuation and Pay for Performance has led to healthcare providers to evolve care delivery methodologies.
The rise of Non-physician providers as the primary healthcare deliverers.

To learn more about e7Health please use the links below:
- Website - LinkedIn

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Taya https://www.linkedin.com/in/tayagordon/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#34 - Healthcare Leadership in 2023

Kem & Taya — Tue, 07 Feb 2023 09:24:22 -0500

Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. In this episode Taya & Kem focus on the topics that are critical for success in 2023 including professional development, recruiting talented staff, maintaining company culture and more!

What you’ll get out of this episode:

Outside the box recruiting strategies
The importance of skill gap assessments
Maintaining direction by increasing collaboration
The power of transparent communication and team development

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Taya https://www.linkedin.com/in/tayagordon/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#33 - The Intersection of Technology & Healthcare Management (Eric Demers)

Kem & Taya — Tue, 20 Dec 2022 12:47:16 -0500

Welcome back to RevDive! Join as Eric Demers, CEO at Madaket Health joins RevDive to discuss the intersection of technology & healthcare management.

Eric Demers is the CEO of Madaket Health. He believes we can transform healthcare delivery through the power of data and interoperability. With more than 25 years of global healthcare experience, Eric has built and scaled leading technology and service companies, from early stage to Fortune 100. He is highly sought-after for speaking and consulting on international health, having advised global entities and governments on critical issues facing healthcare. A growth-minded leader, Eric has founded three companies and exited two. Eric previously served in strategy-focused executive roles at IBM, Accreon, MEDecision and Orion Health. He is a graduate of Brandeis University and The George Washington University School of Medicine and Health Sciences.

What you’ll get out of this episode:

The intersection of technology and healthcare management
The pros and cons of automation as it relates to provider data management
Top tips for reducing administrative burden through automation
Demers' favorite book recommendation

To learn more about Madaket Health please use the links below:
- Website - LinkedIn

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Taya https://www.linkedin.com/in/tayagordon/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#32 - Spill from The Hill with Claire Ernst, JD - Bracing for 2023 CMS Payment and Regulatory Changes

Kem & Taya — Fri, 07 Oct 2022 10:30:05 -0400

Welcome back to RevDive! Join as Claire Ernst, JD, Director of Government Affairs at MGMA joins RevDive to give another Spill from the Hill.

The healthcare industry awaits publication of the 2023 CMS Final Rule later this year. As we await what's to come, our guest sheds light on anticipated changes expected within the payment formula which will impact reimbursement to healthcare organizations and providers dependent upon CMS for funding.

In this episode, we also discuss recent Presidential comments made regarding the national perception of our Public Health Emergency; which leaves many stakeholders scratching their heads and others bracing for current 1135 waivers to come to an end.

Not only are we thrilled to have Claire share her unique "crystal ball" projections for CMS' activities next year, we're excited to bring her back to unpack the 2023 CMS Final Rule after its publication later this year.

What you’ll get out of this episode:

Insights into the Sustainable Growth Rate
Lively discussion on what's happening on, "The Hill"
Preparation strategies for the end of the Public Health Emergency

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Taya https://www.linkedin.com/in/tayagordon/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#31 - The Evolutionary Coding Industry Comes with Major 2023 Updates (Rae Jimenez)

Kem & Taya — Tue, 20 Sep 2022 10:27:02 -0400

Episode Details:
Join in as Rae Jimenez discusses important updates to coding, effective in 2023. Say goodbye to components of 1995 and 1997 documentation guidelines, and say hello to standardized documentation.

Rae expresses that an important metric for efficiency and quality of care is the proper understanding and application of coding guidelines. We discuss the importance of becoming familiar with 2023's guideline modifications.

Coding has evolved into the vast pool of data analytics, in which we can gain accurate information and branch into unique career trajectories. Rae, working for AAPC for 15 years, shares takeaways from her career. Starting off as a clinic assistant, she conveys that an important mindset for healthcare career longevity is that, “there is no small job”.

What you’ll get out of this episode:

Summary of key 2023 coding updates
Evolution and branching out of the coding profession supports multiple facets of the healthcare industry
Important mindsets for career longevity in healthcare

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Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

Learn More About Our Guest
Rae Jimenez - AAPC Website - AAPC LinkedIn

#30 - Becoming an Innovator in Revenue Cycle (Julie Collins)

Kem & Taya — Tue, 02 Aug 2022 11:22:41 -0400

Julie Collins, Innovation Consultant & Lead Faculty for National Science Foundation (NSF) & National Institutes of Health (NIH). Join in as Julie tells our RevDivers how to get into an innovative mindset, what customer discovery means, and how to learn more about the Innovation Corps at NIH where many revenue cycle product leaders got the foundation to succeed. We encourage you to apply these strategies to your process improvements, revenue cycle integrity programs, and general professional outlook.

What You’ll get out of this episode:

The importance of seeking disconfirmation
Why leaning into your skill set can take you places
How to find out more about the resources available at NIH

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Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

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Julie Collins

#29 - Success Stories from True Leaders in Healthcare (Scott Becker)

Kem & Taya — Tue, 19 Jul 2022 11:23:21 -0400

Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Scott Becker of Becker’s Healthcare and McGuire Woods, LLP. Join in as healthcare celebrity Scott Becker talks about how he and his team created the Becker's Health universe, trends he is seeing in the industry today, and the achievements and failures he navigated on his road to success.

What you’ll get out of this episode:

How Becker’s Healthcare became what it is today
Rising costs, staffing shortages and other industry trends that are seriously affecting the industry today
The highs and lows of leadership and self-improvement as a factor of success

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Taya https://www.linkedin.com/in/tayamoheiser/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

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Scott Becker

#28 - The Top 4 Transformation Traps (James Lineberger)

Kem & Taya — Tue, 05 Jul 2022 10:09:01 -0400

Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is James Lineberger, Executive Director for Anesthesia Associates of Boise. Join in as James talks about the top four pitfalls that leaders fall into when assessing data and transforming internal processes.

What You’ll get out of this episode:

Why the rule of thumb can be guiding toward failure
The importance of seeking disconfirmation
Why too much confidence can be bad
How are you trapping yourself into a bad situation

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James Lineberger

#27 - Prioritizing Provider Enrollment for Optimal RCM Efficiency (Kevin R. Mulcahy)

Kem & Taya — Tue, 21 Jun 2022 11:33:55 -0400

Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Kevin Mulcahy, Senior Director of Payer Relations, Special Billing & Provider Enrollment for Mass General Physician Organization. Kevin discusses the trickle-down effect Provider Enrollment and Payer Contract management plays in the overall Revenue Cycle.

What You’ll get out of this episode:

· Remote Central Business Office workforce optimization best practices

· National trends and solutions to address provider enrollment delays

· Incorporating provider enrollment and payer contracting compliance standards into RCM workflows

· Cross-functional knowledge sharing to avoid loss of information in the midst of workforce turnover

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Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

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Kevin Mulcahy

#26 - Innovative Solutions for National Problems: Behavioral Health (Kevin Dedner)

Kem & Taya — Tue, 26 Apr 2022 16:24:57 -0400

Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Kevin Dedner, Founder and CEO of Hurdle Health. Mr. Dedner talks about the revolutions his company has been making in virtual therapy services, publishing “The Joy of the Disinherited-Essays on Trauma, Oppression and Black Mental Health.”, how new CMS policies will impact the future behavioral health landscape, and how to lead multi-faceted teams.

What you’ll get out of this episode

How do you find and collaborate with mental health services providers to close gaps in care?
What are the key takeaways from “The Joy of the Disinherited-Essays on Trauma, Oppression and Black Mental Health” by Kevin Dedner?
How will the CMS’ new focus on mental health services affect the behavioral health landscape?
How do you lead a multi-faceted team through adversity?

Quotables

“For the people who we wanted to serve, there were a lot of barriers that we needed to overcome. The ability for insurance to be accepted, I saw as a critical point for us.”

“The hard truth is that the mental healthcare system is not designed for everyone. We have a system that was really designed for one segment of our population. For far too long, mental health has been a luxury and a privilege.”

“Teletherapy and telehealth are here to stay. If you start to think about work supply shortages and geographical shortages. There are real solutions in telehealth, particularly in the mental health field.”

Recommended Resources

“The Joy of the Disinherited: Essays on Trauma, Oppression, and Black Mental Health” by Kevin Dedner https://www.amazon.com/dp/1737931311/ref=cm_sw_r_sms_api_glt_fabc_3TBG6FCP1DNVR7F2JPB5

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Taya https://www.linkedin.com/in/tayamoheiser/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

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Kevin Dedner https://www.linkedin.com/in/kevin-dedner-mph-/

#25 - MIPS Reporting with RCM Workflow Improvements (Amy Weiser)

Kem & Taya — Tue, 15 Mar 2022 23:54:07 -0400

Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Amy Weiser, lead project coordinator at Quality Insights for the QPP service project. Ms. Weiser explains what a Quality Improvement Organization (QIOs) is and how they support other organizations. Additionally, she explains pressing CMS MIPS updates to help keep listeners up to date.

What you’ll get out of this episode

What is a Quality Improvement Organization (QIOs) and what is their relationship with CMS?
What kind of support does a QIO provide?
What key areas should medical practices focus on to avoid penalties brought on by changes to the Quality Payment Program (QPP)?
What is the MIPS Value Pathway (MVP) Program and what changes will it bring?
Where to get more information on the new SAFER annual EMR self assessment?

Quotables

“We collaborate with providers, communities, and people with Medicare through data driven initiatives.”

“[To improve quality] Selecting measures that are meaningful to your practice is the first thing.”

“In a nutshell, the MIPS Value Pathway program, is designed to reduce provider burden.”

Recommended Resources

“MIPS Value Pathways (MVPs)” https://qpp.cms.gov/mips/mips-value-pathways

Sponsored by: Inovalon

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Taya https://www.linkedin.com/in/tayamoheiser/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#24 - What’s on the Horizon for Healthcare RCM Leaders in 2022, featuring Alexandra Pecci

Kem & Taya — Tue, 01 Mar 2022 23:00:11 -0500

Welcome to RevDive! For those of you who are new to the Podcast, we use this space to hear from and share with healthcare leaders inside and out of the Revenue Cycle. Our Guest today is Alexandra Pecci, freelance writer for Health Leader Media and other top health news outlets. Ms. Pecci takes her experience from interviewing health industry leaders at every-level and gives us the ins and outs of revenue cycle management from the perspective of an outsider.

What you’ll get out of this episode

What does the medical revenue cycle management industry look like from the outside?
Why it is particularly important to provide medical professionals with accurate information?
What are some issues in healthcare stemming from the provider side?
What are some ways to get people interested in revenue cycle management?

Quotables

“You have to make sure you’re not giving bad information...If I point them in the wrong direction or at the wrong regulation, it can have some really serious consequences.”

“I’m not an expert. I interview experts and then share what they have to say with other people who care about it.”

“…payers make the rules and break the rules, and then seemingly make them up as they go along, and change them without telling you."

Recommended Resources

“No Surprises Act Temperature Check with Revenue Cycle Leaders” by Alexandra Pecci https://www.healthleadersmedia.com/revenue-cycle/no-surprises-act-temperature-check-revenue-cycle-leaders
“New Rev Cycle Leaders: Don’t Swoop Into ‘Fix-It’ Mode Until You’ve Taken These 3 Steps” by Alexandra Pecci https://www.healthleadersmedia.com/revenue-cycle/new-rev-cycle-leaders-dont-swoop-fix-it-mode-until-youve-taken-these-3-steps
“3 Issues that Defined 2021 for the Revenue Cycle” by Alexandra Pecci https://www.healthleadersmedia.com/revenue-cycle/3-issues-defined-2021-revenue-cycle

Sponsored by: Inovalon

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Taya https://www.linkedin.com/in/tayamoheiser/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#23 - An Operational Deep-Dive into Cybersecurity for Healthcare Providers

Kem & Taya — Tue, 08 Feb 2022 23:57:30 -0500

What you’ll get out of this episode:

What is “cyber hygiene” and how do we achieve good cyber hygiene?
How is employee burnout impacting cybersecurity risk?
Are cybersecurity policies worth the expense?
How do we protect ourselves from third-party breaches?

Quotables

“Bad Actors are targeting healthcare providers and systems because they know it has a bigger impact than targeting just one organization”

“The general rule of thumb for liability, is that whoever collects the data is responsible to protect the data. So it’s really important that you have a vendor management process”

“Carriers have really evolved into taking a more proactive, pre-breach stance, in protecting their insureds. There are a lot of resources they offer now to help you prevent breaches”

Today's guest: Jenny Jacobsen: https://www.linkedin.com/in/jenny-jacobsen-3b624082/

Recommended Resources

Cyber Risk Management by Jenny Jacobsen https://drive.google.com/file/d/1BtNFWNnQmaKrkGJwoCY3VluxmEHaRQIY/view

Sponsored by: Inovalon

Join the Conversation

We want to hear from our RevDivers! Tell us what topics and people you’d like us to cover in future episodes:

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Follow our hosts on LinkedIn:

Taya https://www.linkedin.com/in/tayamoheiser/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

#22 - Payment Delays Impacting the Industry as a Whole

Kem & Taya — Tue, 11 Jan 2022 20:48:07 -0500

Chances are, like the rest of the industry, you are seeing significant payer delays. In this episode, Sharon Smith, Practice Manager at Virginia Beach Surgery explains the impact of payer delays and how to tackle these issues with payers.

What you’ll get out of this episode:

How do untimely payments impact the revenue cycle?
The role that clean claims play and how to align payer contract language with state regulations
The role of the state insurance commissioner
Best practices to minimize payment delays

Quotables

“Practices need to understand what their contractual obligations are as well as state regulations. One thing that is a frustration is that there are so many caveats in the legislation that allow carriers to bypass”

“Payers should be mandated to say whether or not they are subject to the state regulations to give the claims processor and the practice an indication of whether they can be held accountable”

“Provider reps used to come to the office, we used to actually have reps assigned that we could communicate trends to. With the ways the world has changed we don’t have those deep relationships anymore with provider reps and that adds to the challenge”

Join the Conversation

We want to hear from our RevDivers! Tell us what topics and people you’d like us to cover in future episodes:

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Follow our hosts on LinkedIn:

Taya https://www.linkedin.com/in/tayamoheiser/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

Sponsored by: ABILITY Network

#21 - Tackling Denials Proactively with a Focus on KPIs w/ COO of Physician Services of Einstein Physicians

Kem & Taya — Wed, 05 Jan 2022 22:37:45 -0500

This episode is for revenue cycle leaders, operational leaders and those looking for ways to innovatively approach denial management and operational challenges. In this episode we talk to Lamont Louis, Chief Operating Officer for Physician Services for Einstein Physicians at Jefferson Medical Group in Philadelphia, PA. Mr. Louis talks about identifying financial variances, using the FORM approach to team success, and how to identify critical KPIs from an operational perspective.

What you’ll get out of this episode:

Why does prioritizing a proactive KPI approach matter?
What is the “Financial & Operational Review Meeting” (FORM) and why does it work?
What trends operationally, and for staffing, are being seen right now?
How do organizations operationalize KPI data?

Quotables

“When I arrived 40 years ago, the only metrics I saw were patient visits, and dollar signs. ”

“If we are two years in, and we are still at a loss, then we need to change that dynamic.”

“Don’t be afraid to say, this is not acceptable and we need to be better. It comes with the responsibility of always pushing yourself and your teams to be better”

Recommended Resources

“Proactive to Reactive” by Lamont Louis, MGMA Article https://lnkd.in/e4XJzUpG

Join the Conversation

We want to hear from our RevDivers! Tell us what topics and people you’d like us to cover in future episodes:

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Follow our hosts on LinkedIn:

Taya https://www.linkedin.com/in/tayamoheiser/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

Sponsored by: ABILITY Network

#20 - MGMA Director of Government Affairs Claire Ernst explains Congress’ last minute passing of waivers and delays to looming reimbursement cuts to Medicare for 2022

Kem & Taya — Thu, 16 Dec 2021 00:18:56 -0500

All practices, hospitals, and health systems this is a critical and timely episode. Claire Ernst, Director of Government Affairs breaks down the legislation passed last night by Congress which waived and delayed several looming cuts to Medicare reimbursement for 2022. She covers the PAYGO 4% cuts, conversion factor changes, sequester delays and phased reinstitution, telehealth coverage for 2022 and more! Tune in for essential updates to your 2022 reimbursement outlook!

What you’ll get out of this episode:

What portion of the previously delayed 2021 budget neutrality adjustments were mitigated for the Medicare physician fee schedule conversion factor through CY 2022
The status of the imposition of the 4% statutory pay-as-you-go sequester resulting from the American Rescue Plan Act through CY 2022;
The new plan for the reinstatement of the existing 2% Medicare sequester through March 2022 and more!

Quotables

“Statutory PAYGO has actually never been triggered before for Medicare…we were getting down to the wire and it wasn’t getting done” @ClaireErnstJD

“Anyone who has a physician office lab would want to pay attention to this, the protecting access to medicare act (PAMA) passed in 2014 basically redid the formula for data reporting and coming up with the calculation for reimbursing labs which led certain labs to face up to 15% in cuts…many of those cuts were delayed for a year by the CURES Act through the end of this year”@ClaireErnstJD

“We went from expecting 9.75% cuts in Medicare reimbursement to removing 9% of those cuts” @ClaireErnstJD

“There is momentum [regarding audio only telehealth] if it’s something that’s important to you and your practice, especially if you are in a rural area, get in contact with your members of congress and provide them that data or those anecdotes you may have” @ClaireErnstJD

Recommended Resources

MGMA Washington Connection
CMS Newsroom

Join the Conversation

We want to hear from our RevDivers! Tell us what topics and people you’d like us to cover in future episodes:

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Follow our hosts on LinkedIn:

Taya https://www.linkedin.com/in/tayamoheiser/

Kem https://www.linkedin.com/in/kem-tolliver-bs-cmpe-cpc-cmom-1225b115/

Sponsored by: ABILITY Network

#19: Staying Ahead of Trending Compliance Concerns

Kem & Taya — Tue, 07 Dec 2021 14:07:11 -0500

Details:
Listen in as we hear from Physician and Attorney Reza Ghafoorian on strategies to minimize alarm fatigue while remaining compliant with not so obvious threats that may leave healthcare providers vulnerable to cyberattacks. Our guest gives insight on industry best practices to remain vigilant in protecting your brand and Protected Health Information.

Interviewee:
Reza Ghafforian, MD, Esq, Principal Attorney at G2Z Law Group, PLLC

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: ABILITY Network

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#18: Optimizing Technology, Telehealth & HIEs

Kem & Taya — Wed, 17 Nov 2021 02:19:29 -0500

Details:
Luigi Leblanc joins us for a discussion right at the intersection of public health and technology. How can we optimize use of technology, how is technology being used for niche services, how are programs changing to drive reimbursement for these? Find out the answers to these and more in this episode of RevDive!

Interviewee:
Luigi Leblanc, VP of Technology at Zane Networks

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: ABILITY Network

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#17: Small Brave RCM Leadership Moves

Kem & Taya — Tue, 02 Nov 2021 23:23:17 -0400

Details:
Hi there RevDivers, join us as we learn how to become more brave as leaders with the help of Master Hudson Coach, Nicole Bianchi, author of Small Brave Moves.

Interviewee:
Nicole Bianchi, Partner at Bravium and author of Small Brave Moves

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: ABILITY Network

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#16: Engaging Physicians in Financial Discussions

Kem & Taya — Thu, 28 Oct 2021 18:55:35 -0400

Details:

Hi there RevDivers, join us as we chat about engaging physicians in RCM discussions with Jill Arena, noted author of Physician Heal Thy Financial Self & CEO & Founder of Health e Practices.

Interviewee:

Jill Arena, CEO & Founder of Health e Practices

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: ABILITY Network

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#15: Enhancing the Patient Payment Process

Kem & Taya — Tue, 12 Oct 2021 23:17:06 -0400

Details:
Hi there RevDivers, listen in as Dawn Lunde shares her experience in improving the patient payment experience while integrating patient engagement and health literacy into RCM to develop an informed consumer.

Interviewee:

Dawn Lunde, Senior Director, Sales Strategy Ability Network

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#14: Prioritize Payer Contracting, With Doral Jacobsen, Founding Partner at Prosper Beyond

Kem & Taya — Tue, 05 Oct 2021 19:47:53 -0400

Hi there RevDivers, join us as we interview Doral Jacobsen, founding partner at Prosper Beyond and co-author of MGMA’s “Transitioning to Alternative Payment Models” guidebook. Doral chats with us about the importance of payer contracting and provides some great tips and tricks for when you reach out to negotiate those agreements!

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#13: MGMA’s Upcoming Leadership Conference, featuring Craig Wiberg, Senior Editor at MGMA

Kem & Taya — Tue, 28 Sep 2021 20:35:12 -0400

Today's Guest:
Craig Wiberg, Senior Editor at MGMA

Hi there RevDivers, join us as we interview Craig Wiberg, the legend behind MGMA’s excellent educational content! The October MGMA conference will look very different this year and Craig takes us through all the key things attendees can expect from this in person event!

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#12: Emotional Intelligence & Rev Cycle, featuring Susan Childs, Founder & Healthcare Practice Advisor at Evolution Healthcare Consulting

Kem & Taya — Tue, 21 Sep 2021 22:59:02 -0400

Today's Guest:
Susan Childs, Founder & Healthcare Practice Advisor at Evolution Healthcare Consulting

Hi there RevDivers, join us as we interview Susan Childs, author of Common Nonsense and national practice management consultant. Susan is an expert on revenue cycle, emotional intelligence, and all areas of practice operations.

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#11: Emerging Health Leaders, With Laurie Baedke, Speaker, Author & Educator

Kem & Taya — Wed, 15 Sep 2021 18:19:18 -0400

Today's Guest:

Laurie Baedke. A noted speaker for Harvard Medical School and Cleveland Clinic, author of the Emerging Healthcare Leader, Growth/Edge Podcast Host and Assistant Dean of Physician Leadership Education and Director of Healthcare Leadership Programs at Creighton University.

Hi there RevDivers, join us as we interview Laurie Baedke. As a powerhouse speaker, author, and educator dedicated to healthcare leadership she provides expert guidance on everything from imposter syndrome to dealing with burnout.

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#10: Beyond the Whiteboard, with Dr. Eric Bricker

Kem & Taya — Tue, 31 Aug 2021 16:39:40 -0400

Our Guest:

Eric Bricker, MD, Chief Medical Officer at First Stop Health

Details:

Hi there RevDivers, we had the extreme pleasure of chatting with Dr. Eric Bricker, or as he is better know the Whiteboard Doctor! Dr. Bricker talks everything from price transparency to the importance of objectivity. Fun fact, Dr. Bricker started his career in revenue cycle support and is a huge advocate of all of our RevDivers listening in. Listen into our lively discussion with Dr. Bricker and check out his educational series on YouTube “AHealthcareZ”!

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#9: The Spill From the Hill with Claire Ernst, JD

Kem & Taya — Tue, 17 Aug 2021 23:51:29 -0400

Join us as Claire Ernst, JD shares legislative updates on the recently announced CMS 2022 Proposed Rule that includes proposed changes to the Medicare Physician Fee Schedule, Telehealth and Congressional updates.

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#8: CMS Spends July Dropping Proposed Rules

Kem & Taya — Tue, 03 Aug 2021 23:59:25 -0400

Hi there RevDivers, join Taya for a super speedy review of four proposed rules dropped by CMS in July. Changes to payments, documentation, telehealth services, rural hospitals and more, in this quick and informative recap.

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

Sponsored by: it's Healthcare & Medical Revenue Cycle Specialists LLC

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#7: So You Want To Buy Or Sell A Medical Practice?

Kem & Taya — Wed, 21 Jul 2021 20:59:04 -0400

The public health emergency has created new opportunities to buy and sell medical practices. Today we’ll discuss factors to consider on both sides of this type of transaction. Today's guest, Stephen Kaufman, Esq., Partner at Wright, Constable & Skeen, LLP has seen it all and shares some best practices for buying and selling medical practices in this episode of the podcast.

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#6: Surprise Billing Update & OSHA Tackling COVID-19

Kem & Taya — Tue, 06 Jul 2021 21:42:11 -0400

Join us today as we take a look at the interim surprise billing rule issued July 2, 2021 and OSHA’s Emergency Temporary Standard on COVID-19. Both would be mandatory once finalized and both require significant changes to practice workflows.

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#5: Practice Insights - Prior Authorization at Gastrointestinal Specialists, Inc. (VA)

Kem & Taya — Tue, 22 Jun 2021 17:37:53 -0400

Join us as we chat with Lucien Roberts and gain valuable insights on the challenges facing practices seeking prior authorization and gold-card status. Lucien is the lively practice administrator at Gastrointestinal Specialists in Virginia, former president of the Virginia MGMA chapter, Legislative Advocate Award winner, writer and speaker for Physicians Practice and the AMA.

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#4: The Spill From the Hill with Claire Ernst, JD

Kem & Taya — Tue, 08 Jun 2021 22:59:10 -0400

Join us as legislative and regulatory expert Claire Ernst provides the current Spill from the Hill discussing hot topics in congress including:

Potential Prior Authorization changes
Telehealth restrictions
Sequestration
Comprehensive Debt Collection
...and more!

Find out more in this timely episode and subscribe for future #RevCycle updates with RevDive.

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#3: 2021 Clarifications to Evaluation & Management Medical Decision Making (Part 2: Documentation)

Kem & Taya — Tue, 25 May 2021 18:33:24 -0400

This episode is a continuation of episode #2, part 1, that focused on activities that may be included in time-based scoring of evaluation and management codes (E & M). We discuss the recent E & M clarifications published by the American Medical Association (AMA) that provide further guidance on the use of Medical Decision Making as a factor for leveling E & M services.

These clarifications were published on March 9th, 2021 and effective on January 1, 2021
We will review several key Medical Decision Making (MDM) factors that providers will need to understand for scoring Evaluation & Management Services
The key clarifications that will be discussed include:
- Presenting Problems & Risk
- The term, “Analyzed” for reporting a test in the data column
- The term, “Unique” Test when factoring the number of tests ordered and or reviewed
- The term, “Discussion” between providers, how it can be counted towards MDM and the criteria necessary to factor discussions into MDM
- Factoring in Social Determinants of Health into the table of risk of complications
- Factoring in tests considered but not ordered into the test results category for MDM

Find out in this timely episode and subscribe for future #RevCycle updates with RevDive.

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#2: New Evaluation & Management Time-based Coding Clarifications (Part 1: Time)

Kem & Taya — Tue, 11 May 2021 18:46:20 -0400

In this part 1 episode, Taya Moheiser and Kem Tolliver dive into the changes related to time-based coding of evaluation and management codes.

What time counts?
What time doesn't count?
When did this change become effective?

Find out in this timely episode and subscribe for future #RevCycle updates with RevDive.

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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#1: Congress Grants a Bigger Delay on 2% Sequestration Cuts, for now

Kem & Taya — Tue, 27 Apr 2021 14:47:16 -0400

In this episode, Taya Moheiser and Kem Tolliver discuss the recent vote by Congress to extend the moratorium on the two percent sequestration cuts to Medicare programs. CMS put a hold on payments in anticipation of the delay and it was approved.

So what does this mean long term?
How long is the extension?
What happens after it expires?

Find out in this timely episode and subscribe for future #RevCycle updates with RevDive.

For more information on critical RCM updates, be sure to follow RevDive on our social channels:

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